STRATEGY STUDIO / PUBLIC DATA EXPLORER

HAVEN PARK CHRISTIAN HOUSING AND: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
HAVEN PARK CHRISTIAN HOUSING AND (EIN 38-3026594)
Tax period
2013-01-01 to 2013-12-31
Filed
2014-11-17
IRS object ID
201403219349312110
Schema version
2013v3.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2014-11-17T18:23:45-06:00ReturnTs
Tax Period End2013-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2013-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN383026594EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HAVEN PARK CHRISTIAN HOUSING ANDBusinessNameLine1
Business Name Line2NURSING ASSOCIATION OF ZEELANDBusinessNameLine2
FieldValueIRS element (for citing)
Business Name ControlHAVEBusinessNameControlTxt
Phone7083428100PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line118601 NORTH CREEK DRIVEAddressLine1
CityTINLEY PARKCity
StateILState
ZIP Code60477ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonWILLIAM DEYOUNGPersonNm
Person TitleCFOPersonTitleTxt
Phone7083428100PhoneNum
Signature2014-11-17SignatureDt

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLARRY J OTTEPreparerPersonNm
PTINP01427347PTIN
Preparation2014-11-17PreparationDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts$13,254,106GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressHAVENPARK.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1991FormationYr
Legal Domicile StateMILegalDomicileStateCd
Activity Or MissionCARE OF THE ELDERLY AND SICKActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee251TotalEmployeeCnt
Total Volunteers15TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$3,100PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$10,968,424PYProgramServiceRevenueAmt
CY Program Service Revenue$13,254,106CYProgramServiceRevenueAmt
PY Investment Income$67PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$664,356PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$11,635,947PYTotalRevenueAmt
CY Total Revenue$13,254,106CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$5,947,690PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$6,772,734CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$5,411,447PYOtherExpensesAmt
CY Other Expenses$6,645,840CYOtherExpensesAmt
PY Total Expenses$11,359,137PYTotalExpensesAmt
CY Total Expenses$13,418,574CYTotalExpensesAmt
PY Revenues Less Expenses$276,810PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$164,468CYRevenuesLessExpensesAmt
Total Assets BOY$13,745,829TotalAssetsBOYAmt
Total Assets EOY$2,812,497TotalAssetsEOYAmt
Total Liabilities BOY$10,170,179TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,040,823TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$3,575,650NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$771,674NetAssetsOrFundBalancesEOYAmt
MissionCARE OF THE ELDERLY AND SICKMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$12,348,433ExpenseAmt
DescTO PROVIDE THE GENERAL PUBLIC LONG-TERM HEALTHCARE FACILITIES AND SERVICES FOR THE SICK, INJURED &/OR AGED.Desc
Total Program Service Expenses$12,348,433TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityYes (true)DisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee251EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (true)DelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldMIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PROVIDENCE LIFE SERVICESBusinessNameLine1
FieldValueIRS element (for citing)
Phone7083428100PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line118601 NORTH CREEK DRIVEAddressLine1
CityTINLEY PARKCity
StateILState
ZIP Code60477ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
AARDEMA NORM
VICE CHAIR1.002.00Yes (X)Yes (X)$0$0$0
CLOUSING SHARON
SECRETARY/TR1.002.00Yes (X)Yes (X)$0$0$0
HOFF HOWARD
TRUSTEE1.002.00Yes (X)$0$0$0
KOLDENHOVEN ARNIE
CHAIR1.002.00Yes (X)Yes (X)$0$0$0
NELSON KURT
TRUSTEE1.002.00Yes (X)$0$0$0
PORTER RON
TRUSTEE1.002.00Yes (X)$0$0$0
TAMELING CAL
ASS SEC/TREA1.002.00Yes (X)Yes (X)$0$0$0
SCHUTT RICHARD
CEO45.00Yes (X)$0$444,366$144,635
DEYOUNG WILLLIAM
CFO45.00Yes (X)$0$295,208$66,009
FieldValueIRS element (for citing)
Tot Reportable Comp Rltd Org$739,574TotReportableCompRltdOrgAmt
Total Other Compensation$210,644TotalOtherCompensationAmt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmtAddress Line2ContractorAddress/USAddress/AddressLine2
REST HAVEN ILLIANA CHRISTIAN
18601 NORTH CREEK DRTINLEY PARKIL60477MANAGEMENT$1,178,136
PRIORITY HEALTH
3915 MOMEMTUM PLACECHICAGOIL60689HEALTH INS$635,517
GORDON FOOD SERVICE
520 79TH ST SEGRAND RAPIDSMI49508DIETARY$376,563
MARY FREE BED PROFESSIONAL SERVICE
PO BOX 5805GRAND RAPISMI49503THERAPY & REHAB$207,253235 WEALTHY ST SE
SPECIALIZED PHARMACY
L2650COLUMBUSOH43260PHARMACEUTICALS$136,690
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K7CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescHEALTHCAREDesc
Total Revenue Column$13,254,106TotalRevenueColumnAmt
Related Or Exempt Func Income$13,254,106RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$13,254,106TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$13,254,106TotalRevenueColumnAmt
Related Or Exempt Func Income$13,254,106RelatedOrExemptFuncIncomeAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,645,655TotalAmt
Program Services$5,645,655ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$71,327TotalAmt
Program Services$71,327ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$640,184TotalAmt
Program Services$640,184ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$415,568TotalAmt
Program Services$415,568ProgramServicesAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$927,391TotalAmt
Management And General$927,391ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$119,651TotalAmt
Program Services$119,651ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$28,940TotalAmt
Program Services$28,940ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$119,749TotalAmt
Program Services$119,749ProgramServicesAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$142,750TotalAmt
Management And General$142,750ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$756,108TotalAmt
Program Services$756,108ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$13,759TotalAmt
Program Services$13,759ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$2,481TotalAmt
Program Services$2,481ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$303,790TotalAmt
Program Services$303,790ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$332,285TotalAmt
Program Services$332,285ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$270,432TotalAmt
Program Services$270,432ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
PROVIDER TAXES$986,968$986,968
BAD DEBT EXPENSE$453,157$453,157
NURSING SUPPLIES$432,549$432,549
NURSING THERAPY$425,974$425,974

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,329,856TotalAmt
Program Services$1,329,856ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$13,418,574TotalAmt
Program Services$12,348,433ProgramServicesAmt
Management And General$1,070,141ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$404,633BOYAmt
EOY$736,957EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$972,814BOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,992,293BOYAmt
EOY$1,454,653EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$11,637BOYAmt
EOY$11,304EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$25,238BOYAmt
EOY$13,594EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$689,229LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$93,240LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$10,249,397BOYAmt
EOY$595,989EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$89,817BOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$13,745,829BOYAmt
EOY$2,812,497EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,994,380BOYAmt
EOY$2,040,823EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,155,130BOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$3,020,669BOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$10,170,179BOYAmt
EOY$2,040,823EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,571,379BOYAmt
EOY$771,674EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,271BOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,575,650BOYAmt
EOY$771,674EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$13,745,829BOYAmt
EOY$2,812,497EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$164,468ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$2,639,508OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$18,964CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,993CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$11,901CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,100CurrentTaxYearMinus1YearAmt
Total$45,958TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,746,468CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,035,649CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$11,449,511CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$11,632,780CurrentTaxYearMinus1YearAmt
Current Tax Year$13,254,106CurrentTaxYearAmt
Total$58,118,514TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,765,432CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,047,642CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$11,461,412CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$11,635,880CurrentTaxYearMinus1YearAmt
Current Tax Year$13,254,106CurrentTaxYearAmt
Total$58,164,472TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$58,164,472PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$45,445CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$39,737CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$36,415CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$67CurrentTaxYearMinus1YearAmt
Total$121,664TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$45,445CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$39,737CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$36,415CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$67CurrentTaxYearMinus1YearAmt
Total$121,664TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,810,877CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,087,379CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$11,497,827CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$11,635,947CurrentTaxYearMinus1YearAmt
Current Tax Year$13,254,106CurrentTaxYearAmt
Total$58,286,136TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99790PublicSupportCY509Pct
Public Support PY5090.99620PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$689,229OtherCostOrOtherBasisAmt
Depreciation$93,240DepreciationAmt
Book Value$595,989BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$595,989TotalBookValueLandBuildingsAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D, PAGE 3, PART XFormAndLineReferenceDesc
ExplanationASC 740 FOOTNOTE THE CORPORATIONS ACCOUNT FOR UNCERTAIN TAX POSITIONS WITH ASC SUBTOPIC 740 -10, INCOME TAXES - OVERALL, WHICH ADDRESSES THE DETERMINATION OF HOW TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. UNDER ASC SUBTOPIC 740 -10, THE CORPORATIONS MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. ASC SUBTOPIC 740-10 ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST, AND PENALTIES ON INCOME TAXES AND ACCOUNTING IN INTERIM PERIODS, AND REQUIRES INCREASED DISCLOSURES. AS OF DECEMBER 31, 2013 AND 2012, THE CORPORATIONS DO NOT HAVE A LIABILITY FOR ANY UNRECOGNIZED TAX BENEFITS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsYes (X)TravelForCompanionsInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmt
SCHUTT RICHARD
CEO$406,240$21,192$16,934$114,318$30,317$589,001
DEYOUNG WILLLIAM
CFO$269,201$14,305$11,702$35,648$30,361$361,217

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART IIIFormAndLineReferenceDesc
ExplanationQUESTION 1A THE ORGANIZATION PROVIDES AN ALLOWANCE FOR UP TO 10 BOARD MEMBERS TO ATTEND THE ANNUAL ASSOCIATION CONVENTION TO PROVIDE MORE IN DEPTH KNOWLIEDGE OF THE SENIOR CARE INDUSTRY. THE COST OF TRAVEL FOR SPOUSES IS PERMITTED AS LONG AS THE TOTAL DOES NOT EXCEED THE ESTABLISHED ALLOWANCE AMOUNT. DOCUMENTATION OF ATTENDANCE AT THE ANNUAL CONVENTION IS REQUIRED. THE ORGANIZATIN HAS ESTABLISHED A SENIOR EXECUTIVE MANAGEMENT PROGRAM WHICH ALLOWS STATED EMPLOYEES TO JOIN A FITNESS CENTER. ELIGIBLE EMPLOYEES THAT ENROLL ARE REQUIRED TO BE ACTIVELY UTILIZING THE FITNESS CENTER. QUESTION 4B REST HAVEN HAS ESTABLISHED A NONQUALIFIED DEFERRED COMPENSATION PLAN IN AN EFFORT TO RETAIN SELECTED OFFICERS ON A LONG TERM BASIS. THE FOLLOWING IS A SCHEDULE OF THE OFFICERS AND THE ANNUAL CONTRIBUTION TO THE PLAN: RICHARD SCHUTT 96,226 WILLIAM DEYOUNG 24,206 IN 2005, THE BOARD OF DIRECTORS ESTABLISHED A RETENTION INCENTIVE PLAN FOR CERTAIN OFFICERS. THIS PLAN RECOGNIZES THE HISTORIC CONTRIBUTION OF THE EXECUTIVES WITH THE ORGANIZATION UNTIL NORMAL RETIREMENT AGE. AMONG VARIOUS CRITERIA, IN ORDER TO QUALIFY FOR THE BENEFIT, THE EXECUTIVE WILL NEED TO BE CONTINOUSLY EMPLOYED THRU AND UNTIL FUTURE DATE. THE OPRGANIZATIONS PAYMENTS INTO THE PLAN ARE RECORDED ON THE 990 AS DEFERRED COMPENSATION. HOWEVER, THE EXECUTIVE HAS NOT RECEIVED THESE MONIES AND WILL ONLY BE ELIGIBLE TO RECEIVE THEM BASED UPON ACHIEVEMENT OR SATISFACTION OF SOME FUTURE EVENTS. THE PLAN CONTRIBUTIONS ARE NOT UNDER THE CONTROL OF THE EXECUTIVES, THEY REMAIN THE ASSET OF THE ORGANIZATION, AND THE ENTIRE PLAN IS SUBJUECT TO A FULL RISK FORFEITURE BY THE INDIVIDUAL. QUESTIONS 5A AND 6A THE EXECUTIVE COMPENSATION PROGRAM HAS TWO MAJOR ELEMENTS: SALARY, OR BASE PAY, AND VARIABLE PAY. THE SALARY REFLECTS THE VALUE OF AN EXECUTIVE'S CAPABALITIES AND EXPERIENCE. THE VARIABLE PAY REFLECTS THE ORGANIZATIONS COMMITMENT TO PAY FOR SPECIFIC PERFORMANCE TOWARDS THE ORGANIZATIONS GOALS. THE VARIABLE PAY IS AWARDED BASED UPON A SPECIFIC REVIEW OF GOALS AND OBJECTIVES (INCLUDING THOSE WHICH RELATE TO MISSION, OPERATIONAL EFFICIENCY, FINANCIAL EFFECTIVENESS, AND STRATEGIC GOALS). SEMI-ANNUALLY THE COMPENSATION COMMITTEE REVIEWS, ASSESSES AND DETERMINES ANY AWARD UNDER THE VARIABLE PAY COMPONENT. EXECUTIVE EMPLOYEE BENEFITS ARE REVIEWED BY THE COMPENSATION COMMITTEE AND OUTSIDE CONSULTANTS TO INSURE THEY ARE COMPETIVIE AND IN LINE WITH COMMON PRACTICE FOR SIMILAR POSITIONS IN SIMILARLY SIZED AND TYPE ORGANIZATIONS. THE COMMITTEE RECIEVES AND EXECUTIVE COMPENSATION OPINION NOTING THAT THE ORGANIZATIONS EXECUTIVE COMPENSATION FALLS WITHIN THE RANGE OF COMPARABLE POSITIONS WITHIN THE SAME INDUSTRY. THE REPORT/OPINION ALSO NOTES THAT THE STATED REQUIREMENTS OF ENSURING INDEPENDENCE OF COMPENSATION DELIBERATIONS FOR SENIOR EXECUTIVES ARE MET.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 3RESPONSIBILITIES PAID THROUGH MANAGEMENT FEES TO REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME DBA PROVIDENCE LIFE SERVICES.
FORM 990, PAGE 6, PART VI, LINE 11BA DRAFT OF THE 990 WAS PREPARED AND AN INITIAL REVIEW WAS MADE BY THE CONTROLLER, CFO AND CEO. UPON REVIEW AND APPROVAL, A COMPLETED COPY OF THE 990 IS PROVIDED TO THE FULL BOARD AT THE SUBSEQUENT BOARD MEETING, AFTER FILING.
FORM 990, PAGE 6, PART VI, LINE 12CBOARD MEMBERS ANNUALLY REVIEW AND UPDATE THEIR CONFLICT OF INTEREST STATEMENTS.
FORM 990, PAGE 6, PART VI, LINE 15ATHE EXECUTIVE COMPENSATION PROGRAMS PRIMARY OBJECTIVE IS TO PROVIDE COMPETITIVE TOTAL PAY OPPORTUNITIES THAT HELP ATTRACT, REWARD AND RETAIN CRITICAL LEADERSHIO TALENT IN ORDER TO ACHIEVE THE ORGANIZATIONS MISSION AND STRATEGIC INITIATIVES. REST HAVEN ESTABLISHES ITS EXECTUIVE COMPENSATION RANGES THROUGH A WRITTEN POLICY AND BY COMPARING ITSELF TO ORGANIZATIONS OF SIMILAR SIZE AND TYPE - USING OBJECTIVE, THIRD-PARTY DATA. A COMPENSATION COMMITTEE OF INDEPENDENT DIRECTORS RECOMMENDS, AND THE BOARD OF DIRECTORS APPROVES, THE SALARY RANGES AND REVIEWS TOTAL COMPENSATION FOR EXECUTIVES ON AN ANNUAL BASIS. THE ORGANIZATION ROUTINELY USES KNOWLEDGEABLE EXTERNAL CONSULTANTS TO ADVISE ON THE PROCESS AND HAS RECEIVED AFFIRMATION OF COMPLIANCE WITH IRS GUIDELINES FOR REASONABLENSS OF EXECUTIVE COMPENSATION IN TAX-EXEMPT ENTITIES.
FORM 990, PAGE 6, PART VI, LINE 15BTHE EXECUTIVE COMPENSATION PROGRAMS PRIMARY OBJECTIVE IS TO PROVIDE COMPETITIVE TOTAL PAY OPPORTUNITIES THAT HELP ATTRACT, REWARD AND RETAIN CRITICAL LEADERSHIO TALENT IN ORDER TO ACHIEVE THE ORGANIZATIONS MISSION AND STRATEGIC INITIATIVES. REST HAVEN ESTABLISHES ITS EXECTUIVE COMPENSATION RANGES THROUGH A WRITTEN POLICY AND BY COMPARING ITSELF TO ORGANIZATIONS OF SIMILAR SIZE AND TYPE - USING OBJECTIVE, THIRD-PARTY DATA. A COMPENSATION COMMITTEE OF INDEPENDENT DIRECTORS RECOMMENDS, AND THE BOARD OF DIRECTORS APPROVES, THE SALARY RANGES AND REVIEWS TOTAL COMPENSATION FOR EXECUTIVES ON AN ANNUAL BASIS. THE ORGANIZATION ROUTINELY USES KNOWLEDGEABLE EXTERNAL CONSULTANTS TO ADVISE ON THE PROCESS AND HAS RECEIVED AFFIRMATION OF COMPLIANCE WITH IRS GUIDELINES FOR REASONABLENSS OF EXECUTIVE COMPENSATION IN TAX-EXEMPT ENTITIES.
FORM 990, PAGE 6, PART VI, LINE 19THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9EQUITY TRANSFER FOR ASSETS AND DEBT 2,639,508

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1RPPII LLCBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line118601 NORTH CREEK DRIVEAddressLine1
CityTINLEY PARKCity
StateILState
ZIP Code60477ZIPCode
FieldValueIRS element (for citing)
Primary ActivitiesRENTALPrimaryActivitiesTxt
Legal Domicile StateILLegalDomicileStateCd
Total Income$22,179TotalIncomeAmt
End Of Year Assets$629,384EndOfYearAssetsAmt
Direct Controlling NAN/ADirectControllingNACd

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1REST HAVEN ILLIANA CHRISTIANBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line118601 N CREEK DRIVEAddressLine1
CityTINLEY PARKCity
StateILState
ZIP Code60477ZIPCode
FieldValueIRS element (for citing)
EIN362382853EIN
Primary ActivitiesHEALTHCAREPrimaryActivitiesTxt
Legal Domicile StateILLegalDomicileStateCd
Exempt Code Section501C3ExemptCodeSectionTxt
Public Charity Status7PublicCharityStatusTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled OrganizationfalseControlledOrganizationInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1PROVIDENCE MANAGMENT & DEVELOPMENTBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line118601 N CREEK DRAddressLine1
CityTINLEY PARKCity
StateILState
ZIP Code60477ZIPCode
FieldValueIRS element (for citing)
EIN363774205EIN
Primary ActivitiesMGMT & ITPrimaryActivitiesTxt
Legal Domicile StateILLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Controlled OrganizationfalseControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
PROVIDENCE MGMT & DEVELOPMENT
P$142,750FMV
REST HAVEN ILLIANA CHRISTIAN
P$1,178,136FMV
REST HAVEN ILLIANA CHRISTIAN
K$474,768FMV